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https://www.readbyqxmd.com/read/28817760/association-between-hypercoagulability-and-severe-obstructive-sleep-apnea
#1
Seung-No Hong, Hee-Chul Yun, Joon Hyuk Yoo, Seung Hoon Lee
Importance: Obstructive sleep apnea (OSA) is related to the increased risk of cardiovascular disease. Although the pathogenesis of this association remains unclear, an alteration in coagulability is suspected as a link. Objective: To investigate the association between the severity of OSA and blood coagulability. Design, Setting, and Participants: A retrospective cohort study conducted at a tertiary care university hospital evaluated 146 patients with OSA from January 1, 2009, to July 31, 2015...
August 17, 2017: JAMA Otolaryngology—Head & Neck Surgery
https://www.readbyqxmd.com/read/28817446/bevacizumab-as-an-effective-treatment-for-radiation-necrosis-after-radiotherapy-for-melanoma-brain-metastases
#2
Isabella C Glitza, Nandita Guha-Thakurta, Neil M D'Souza, Rodabe N Amaria, Susan L McGovern, Ganesh Rao, Jing Li
Radiation necrosis (RN) is a potential late complication of radiotherapy for intracranial malignancy, which is often associated with significant neurological morbidity. Prolonged treatment with high-dose corticosteroids or surgical resection has been the standard care for RN, but protracted steroid use can lead to significant side effects and surgical resection is not always feasible. The antivascular endothelial growth factor monoclonal antibody bevacizumab induces clinical and radiographic improvements in RN, with overall good tolerance...
August 16, 2017: Melanoma Research
https://www.readbyqxmd.com/read/28816935/perimesencephalic-nonaneurysmal-subarachnoid-hemorrhage-caused-by-transverse-sinus-thrombosis-a-case-report-and-review-of-literature
#3
Fang-Wang Fu, Jie Rao, Yuan-Yuan Zheng, Liang Song, Wei Chen, Qi-Hui Zhou, Jian-Guang Yang, Jiang-Qiong Ke, Guo-Qing Zheng
RATIONALE: Perimesencephalic nonaneurysmal subarachnoid hemorrhage (PNSAH) is characterized by a pattern of extravasated blood restricted to the perimesencephalic cisterns, normal angiographic findings, and an excellent prognosis with an uneventful course and low risks of complication. The precise etiology of bleeding in patients with PNSAH has not yet been established. The most common hypothesis is that PNSAH is venous in origin. Intracranial venous hypertension has been considered as the pivotal factor in the pathogenesis of PNSAH...
August 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28816298/-multiple-endoscopy-for-the-treatment-of-upper-urinary-tract-calculi-following-ileal-conduit-a-case-report-and-literature-review
#4
B Wang, J F Ye, L Zhao, H Bi, J Lu, L L Ma
Upper urinary tract calculi with infection is a quite difficult acute urologic emergency. And what is more, upper urinary tract obstruction after radical cystectomy following urinary diversion may be fatal in the vulnerable patients with this kind of situation. Postoperative anatomy and other factors affect the upper urinary tract calculi, and urinary tract infection greatly increased the risk. But it is particularly difficult to handle with patients with poor general condition and septic shock treatment, so how to optimize the selection program is worth further studying...
August 18, 2017: Beijing da Xue Xue Bao. Yi Xue Ban, Journal of Peking University. Health Sciences
https://www.readbyqxmd.com/read/28816093/vascular-complications-following-intra-aortic-balloon-pump-implantation-an-updated-review
#5
Monique M de Jong, Roberto Lorusso, Fatima Al Awami, Francesco Matteuci, Orlando Parise, Pieter Lozekoot, Massimo Bonacchi, Jos G Maessen, Daniel M Johnson, Sandro Gelsomino
BACKGROUND: The use of the intra-aortic balloon pump (IABP) as a support device remains controversial due to the fact that a number of studies have shown no benefit in end mortality whilst using this device. One of the reasons for this could be the increase in vascular complications when using the pump. Therefore, the aim of the present review was to assess the current literature available with regards to IABP vascular complications during the clinical situation. METHODS: A literature search was performed, searching for IABP complications in adult human studies between 1990 and 2016...
August 1, 2017: Perfusion
https://www.readbyqxmd.com/read/28815079/implementation-of-minimally-invasive-esophagectomy-in-a-tertiary-referral-center-for-esophageal-cancer
#6
Magnus Nilsson, Satoshi Kamiya, Mats Lindblad, Ioannis Rouvelas
BACKGROUND: Esophagectomy remains the gold standard in the curative intent treatment of resectable esophageal cancer. However, this procedure is complex and associated with high risk of complications. In an effort to reduce the postoperative morbidity associated with open esophagectomy various minimally invasive techniques have been introduced and developed during the recent years. The aim of the current study was to present our 4.5-year experience of the gradual implementation of various minimally invasive esophagectomy (MIE) techniques in our tertiary referral center...
July 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28815031/capsule-retention-related-to-small-bowel-capsule-endoscopy-a-large-european-single-center-10-year-clinical-experience
#7
Artur Nemeth, Gabriele Wurm Johansson, Jörgen Nielsen, Henrik Thorlacius, Ervin Toth
BACKGROUND: The most concerning complication of video capsule endoscopy (VCE) is capsule retention (CR) in the gastrointestinal (GI) tract although clinical outcome and management of patients with CR are still uncertain in a large single center material. OBJECTIVES: The aim of this retrospective study was to investigate incidence, causes, risk factors, management and clinical outcomes of CR in a large single center between 2001 and 2011. RESULTS: 2401 consecutive small-bowel (SB) VCEs were performed...
August 2017: United European Gastroenterology Journal
https://www.readbyqxmd.com/read/28814767/application-of-the-onodera-prognostic-nutrition-index-and-neutrophil-to-lymphocyte-ratio-in-risk-evaluation-of-postoperative-complications-in-crohn-s-disease
#8
Wei-Ming Kang, Chang-Zhen Zhu, Xiao-Xu Yang, Jian-Chun Yu, Zhi-Qiang Ma, Xin Ye, Kang Li, Dong Liu
This study aimed to investigate application of Onodera prognostic nutrition index (OPNI) and neutrophil-to-lymphocyte ratio (NLR) in evaluating risk of postoperative complications in Crohn's disease (CD). Clinical data of 108 postoperative CD patients in 9 years were respectively reviewed. OPNI and NLR were within 1 week preoperatively. Average OPNI was 38.8 ± 8.2 and significantly lower in patients with: CD type B3; lymphopenia; decreased haemoglobin, prealbumin, and albumin; and daily enteral nutrition <500 kcal/d...
August 16, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28814595/bleeding-ectopic-duodenal-varix-use-of-a-new-microvascular-plug-mvp-device-along-with-transjugular-intrahepatic-portosystemic-shunt-tipss
#9
Richa Bhardwaj, Gaurav Bhardwaj, Erik Bee, Raffi Karagozian
Ectopic varices (ECV) occur along the gastrointestinal (GI) tract outside the common variceal sites and represent 2%-5% of all GI variceal bleeds with mortality rates up to 40%. Management is challenging because of inaccessibility and increased risk of rebleeding. We report what is to our knowledge the first clinical use of a new microvascular plug (MVP) with transjugular intrahepatic portosystemic shunt (TIPSS) for a bleeding duodenal varix (DV). A 68-year-old man presented with melena. Endoscopy demonstrated a grade II varix in the second part of the duodenum with red wale sign...
August 16, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28814423/portal-hypertension-and-its-management-in-children
#10
REVIEW
Tassos Grammatikopoulos, Patrick James McKiernan, Anil Dhawan
Portal hypertension (PHT), defined as raised intravascular pressure in the portal system, is a complication of chronic liver disease or liver vascular occlusion. Advances in our ability to diagnose and monitor the condition but also predict the risk of gastrointestinal bleeding have enabled us to optimise the management of children with PHT either at a surveillance or at a postbleeding stage. A consensus among paediatric centres in the classification of varices can be beneficial in streamlining future paediatric studies...
August 16, 2017: Archives of Disease in Childhood
https://www.readbyqxmd.com/read/28814247/fluid-and-medication-considerations-in-the-traumatized-patient
#11
Amita Misir
This article reviews fluid therapy and medications in pediatric trauma. For resuscitation in the setting of hemorrhagic shock, isotonic crystalloid solution is the first-line agent of choice. Colloid solutions offer no additional benefit, introduce possible increased risks and cost more than crystalloids. Blood products, starting with pRBCs, should be introduced after 20-40 ml/kg of crystalloid has been administered if there is ongoing need for volume replacement. The use of a massive transfusion protocol of 1:1:1 (if >30 kg) or 30:20:20 (if <30 kg) of pRBCs:FFP:platelets is suggested after an initial 30 ml/kg of pRBcs have been administered...
August 14, 2017: Current Pediatric Reviews
https://www.readbyqxmd.com/read/28813701/uterine-cervical-length-measurement-to-reduce-length-of-stay-in-patients-admitted-for-threatened-preterm-labor-a-randomized-trial
#12
Montse Palacio, Javier Caradeux, Miriam Sánchez, Teresa Cobo, Francesc Figueras, Oriol Coll, Eduard Gratacós, Vicenç Cararach
OBJECTIVE: To study whether knowledge of cervical length (CL) is useful in reducing the length of hospital stay in women admitted because of threatened preterm labor. METHODS: We performed a single-center, parallel, randomized trial at the Hospital Clínic of Barcelona. Inclusion criteria were single pregnancy, gestational age (GA) between 24+0 and 35+6 weeks, Bishop score <6, no parturition within 24-48 h after admission, and no clinical signs of chorioamnionitis, vaginal bleeding, or nonreassuring fetal status...
August 17, 2017: Fetal Diagnosis and Therapy
https://www.readbyqxmd.com/read/28813466/comprehensive-comparison-of-neonate-and-adult-human-platelet-transcriptomes
#13
Eva Caparrós-Pérez, Raúl Teruel-Montoya, Mª José López-Andreo, Mª Carmen Llanos, José Rivera, Verónica Palma-Barqueros, Jose E Blanco, Vicente Vicente, Constantino Martínez, Francisca Ferrer-Marín
Understanding the underlying mechanisms of the well-substantiated platelet hyporeactivity in neonates is of interest given their implications for the clinical management of newborns, a population at higher bleeding risk than adults (especially sick and preterm infants), as well as for gaining insight into the regulatory mechanisms of platelet biology. Transcriptome analysis is useful in identifying mRNA signatures affecting platelet function. However, human fetal/neonatal platelet transcriptome analysis has never before been reported...
2017: PloS One
https://www.readbyqxmd.com/read/28811987/early-complications-and-outcomes-in-adult-spinal-deformity-surgery-an-nsqip-study-based-on-5803-patients
#14
Nathan J Lee, Parth Kothari, Jun S Kim, John I Shin, Kevin Phan, John Di Capua, Sulaiman Somani, Dante M Leven, Javier Z Guzman, Samuel K Cho
STUDY DESIGN: Retrospective analysis. OBJECTIVE: The purpose of this study is to determine the incidence, impact, and risk factors for short-term postoperative complications following elective adult spinal deformity (ASD) surgery. METHODS: Current Procedural Terminology codes were used to query the American College of Surgeons National Surgical Quality Improvement Program (ACS NSQIP) for adults who underwent spinal deformity surgery from 2010 to 2014...
August 2017: Global Spine Journal
https://www.readbyqxmd.com/read/28811212/incidence-and-risk-factors-of-delayed-intracranial-hemorrhage-in-emergency-department
#15
Byunghyun Kim, Hyeonjeong Jeong, Joonghee Kim, Tackeun Kim, Kyuseok Kim, Heeyoung Lee, Soyeon Ahn, Yoo Hwan Jo, Jae Hyuk Lee, Ji Eun Hwang
OBJECTIVES: This study was performed to identify the risk factors for delayed intracranial hemorrhage and develop a risk stratification system for disposition of head trauma patients with negative initial brain imaging. METHODS: The data source was National Health Insurance Service-National Sample Cohort of Korea. We analyzed adult patients presenting to the ER from January 2004 to September 2012, who underwent brain imaging and discharged with or without short-term observation no longer than two days...
August 4, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28811090/guanosine-exerts-antiplatelet-and-antithrombotic-properties-through-an-adenosine-related-camp-pka-signaling
#16
Francisco Fuentes, Marcelo Alarcón, Lina Badimon, Manuel Fuentes, Karl-Norbert Klotz, Gemma Vilahur, Sonja Kachler, Teresa Padró, Iván Palomo, Eduardo Fuentes
BACKGROUND: Guanosine is a natural product and an endogenous nucleoside that has shown to increase during myocardial ischemia. Platelets are critically involved in ischemic coronary events. It remains unknown, however, whether guanosine may affect platelet activation and function. We sought to investigate the potential antiplatelet and antithrombotic properties of guanosine and decipher the mechanisms behind. METHODS: We firstly assessed the effects of guanosine on platelet activation/aggregation upon stimulation with several platelet agonists including adenosine diphosphate (ADP), collagen, arachidonic acid (AA), and TRAP-6...
August 7, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28811088/primary-prevention-aspirin-use-in-high-risk-patients-a-pharmacist-intervention-and-comparison-of-risk-stratification-tools
#17
Scott A Coon, Amie D Brooks, Stephen E Wolff
OBJECTIVES: The objectives of this project are 1) to describe aspirin use for primary prevention in an underserved, minority population; 2) to determine the impact of a pharmacist-led intervention on the prevalence of aspirin use for primary prevention; and 3) to compare aspirin indications based on Framingham Risk Score (FRS) and atherosclerotic cardiovascular disease (ASCVD) risk score. METHODS: Men and women age 45-79 and 55-79 years, respectively, without ASCVD were screened for aspirin use...
August 12, 2017: Journal of the American Pharmacists Association: JAPhA
https://www.readbyqxmd.com/read/28810692/resveratrol-protects-from-lipopolysaccharide-induced-inflammation-in-the-uterus-and-prevents-experimental-preterm-birth
#18
María Victoria Bariani, Fernando Correa, Emma Leishman, Ana Paula Domínguez Rubio, Andreína Arias, Aníbal Stern, Heather B Bradshaw, Ana María Franchi
STUDY QUESTION: Is resveratrol able to prevent the lipopolysaccharide (LPS)-induced preterm labor in 15-day pregnant BALB/c mice? SUMMARY ANSWER: Resveratrol prevented the LPS-induced onset of preterm labor in 64% of the cases and showed anti-inflammatory and tocolytic effects by downregulating COX-2 and iNOS expression and NOS activity, and by changing the uterine prostaglandin and endocannabinoid profiling. WHAT IS KNOWN ALREADY: Genital tract infections by Gram-negative bacteria are a common complication in human pregnancy and have been shown to increase risk of preterm delivery...
August 1, 2017: Molecular Human Reproduction
https://www.readbyqxmd.com/read/28810573/warfarin-induced-life-threatening-bleeding-associated-with-a-cyp3a4-loss-of-function-mutation-in-an-acute-limb-ischemia-patient-case-report-and-review-of-the-literature
#19
Xiao-Wei Ma, Chang-Ning Hao, Zhi-Chun Gu, Meng Ye, Min Li, Lan Zhang
Patients with acute limb ischemia, deep venous thrombosis and pulmonary artery embolism may be treated with warfarin. The dose-response interaction of warfarin is associated with numerous factors, depending on which an uncommon life-threatening bleeding may occur. The present case study reported on a patient with acute limb ischemia and a history of warfarin-induced bleeding ten years previously and who again developed life threatening bleeding associated with warfarin treatment and received vascular surgery...
August 2017: Experimental and Therapeutic Medicine
https://www.readbyqxmd.com/read/28810280/-dual-antiplatelet-therapy-in-the-perioperative-period-to%C3%A2-continue-or-discontinue-treatment
#20
Jürgen Koscielny, Christian von Heymann, Uwe Zeymer, Jochen Cremer, Michael Spannagl, Joachim Labenz, Evangelos Giannitsis, Franz Goss
Background For secondary prevention of acute coronary syndrome, guidelines recommend dual antiplatelet therapy (DAPT) with acetylsalicylic acid and a P2Y12 receptor antagonist such as clopidogrel, prasugrel or ticagrelor for a period of 12 months. Often, uncertainty exists with respect to surgical or diagnostic procedures in these high-risk patients: can the DAPT be continued without interruption? If not, what is the recommended withdrawal strategy? What should be considered for the perioperative management? Methods An interdisciplinary group of experienced experts in the fields of cardiology, cardiac surgery, gastroenterology, anaesthesiology, intensive care and haemostaseology developed recommendations relevant to daily clinical practice based on the current scientific evidence...
August 2017: Deutsche Medizinische Wochenschrift
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